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 Other evidence-informed preventative care and screening provided for in comprehensive
guidelines supported by HRSA for women.

For more information contact the Plan Administrator or visit
http://www.healthcare.gov/news/factsheets/2010/07/preventive-services-
list.html#CoveredPreventiveServicesforAdults.

Coverage of Clinical Trials. The Plan will not deny a participant, covered spouse or
dependent child the right to participate in an approved clinical trial for which such participant
or covered spouse or dependent child is a qualified individual with respect to the treatment of
cancer or another life-threatening disease or condition, or deny (or limit or impose additional
conditions on) the coverage of routine patient costs for drugs, devices, medical treatment, or
procedures provided or performed in connection with participation in such an approved
clinical trial. A participant, covered spouse or dependent child participating in such an
approved clinical trial will not be discriminated against on the basis of his or her participation
in the approved clinical trial. For purposes of this provision, the terms “qualified individual,”
“life threatening disease or condition,” approved clinical trial” and “routine patient costs”
will have the same meaning as found in the Public Health Services Act section 2709.

Cost Sharing. The Plan will comply with the overall cost-sharing limit (i.e., out-of-pocket
maximum) mandated by the ACA, indexed annually. For purposes of this provision, cost-
sharing includes deductibles, co-insurance, co-payments or similar charges, and any other
required expenditure that is a qualified medical expense with respect to Essential Health
Benefits covered under the Plan. Cost-sharing will not include premiums, balance billing
amounts for non-network providers or spending for services that are not covered under the
Plan.

Rescissions of Coverage. The Plan will not cancel or discontinue coverage under a medical
option with a retroactive effect with respect to a participant or covered spouse or dependent
except in the event of fraud or intentional misrepresentation.

Patient Protections. To the extent applicable, the medical option(s) under the Plan will
comply with the patient protections regarding choice of health care professionals and
emergency care services under Public Health Services Act section 2719A and the regulations
and guidance issued thereunder.

Pregnancy And Childbirth. The Plan generally may not, under federal law, restrict benefits
for any hospital length of stay in connection with childbirth for the mother or newborn child
to less than 48 hours following a normal delivery, or less than 96 hours following a cesarean
section, or require that a health care provider obtain authorization from the Plan or any
insurance issuer for prescribing a length of stay not in excess of the above periods. However,
federal law generally does not prohibit the mother’s or newborn’s attending provider, after
consulting with the mother, from discharging the mother or her newborn earlier than 48
hours (or 96 hours as applicable).

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